California legislators are attempting to clear the way for undocumented immigrants to buy health insurance through the state’s insurance exchange — potentially setting a national precedent.

The fusion of illegal immigration and the Affordable Care Act, two of the most highly charged elements on the periodic table of U.S. politics, could engender a combustible reaction, especially in an election year.

Immigrants living in the country illegally are excluded from the insurance-expanding provisions of ObamaCare. They are not eligible for Medicaid (called Medi-Cal in California), and they are not allowed to purchase a health plan from the federal marketplace or any of the state exchanges.

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A Crain’s investigation shows how Health Republic, the insurance company that was supposed to be about people, not profits, misled its customers and ran itself into the ground.

It’s been decades since a New York health insurer has cratered so dramatically. Providers told Crain’s they signed contracts to treat Health Republic members because they assumed the insurer had been fully vetted by the state. The Cuomo administration had even issued press releases in 2014 and 2015 crediting DFS’ oversight as evidence of the state’s role in keeping premiums affordable.

“We feel betrayed,” said Robert Glazer, chief executive of ENT and Allergy Associates, a large medical practice with 173 physicians. The only warning signs of trouble were early last year, when Health Republic delayed claim payments by three to four months.

“We have no idea if our doctors will be reimbursed,” said Glazer, whose practice is owed more than $650,000. Even if money is recovered, Oechsner said payments to providers “would likely be modest at best.”

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A potential shakeup in Arizona’s Affordable Care Act marketplaces is resurrecting President Barack Obama’s 2010 health-care law as a political issue in this year’s U.S. Senate race.

The developments mean customers will have fewer subsidized plans to pick from next year, and in some rural counties, they could have no options at all. UnitedHealthcare, the national insurance giant, on Tuesday signaled that it intends to abandon Arizona’s Affordable Care Act marketplace in 2017. Blue Cross Blue Shield of Arizona, the only other insurer to offer plans in all of Arizona’s 15 counties, also is considering pulling out of some areas.

Arizona voters could face a stark choice on the issue in November.

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UnitedHealth is withdrawing from most of the 34 ObamaCare Exchanges in which it currently sells, citing losses of $650 million in 2016. A recent Kaiser Family Foundation report indicates UnitedHealth’s departure will leave consumers on Oklahoma’s Exchange with only one choice of insurance carriers.

Michael Cannon of the Cato Institute explains five results of UnitedHealth’s withdrawal from the exchanges:

1. UnitedHealth’s departure shows ObamaCare is suffering from self-induced adverse selection.

2. UnitedHealth’s departure is bad news for other carriers.

3. UnitedHealth’s departure shows ObamaCare premiums will continue to rise.

4. There will be more exits.

5. UnitedHealth’s departure shows quality of coverage under ObamaCare will continue to fall.

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Donald Trump’s healthcare plan is a “whipsaw of ideas” and an “incoherent mishmash that could jeopardize coverage for millions of newly insured people,” according to conservative health policy experts. Mr. Trump’s health care platform “resembles the efforts of a foreign student trying to learn health policy as a second language,” according to AEI’s Tom Miller. AEI’s Jim Capretta adds that replacing the ACA would require a “herculean effort, with clear direction and a clear vision of what would come next. I just don’t see that in Trump’s vague plans to repeal the law and replace it with something beautiful and great.” Trump must “discard some of his ideas, like the importation of prescription drugs, because they would be damaging and unworkable,” according to Grace-Marie Turner. “And he has to flesh out his other proposals with much more detail if he hopes to persuade voters that he has a credible plan to replace Obamacare.” Robert Laszewski, a former insurance executive, called Mr. Trump’s health care proposals “a jumbled hodgepodge of old Republican ideas, randomly selected, that don’t fit together.”

Obamacare created a system that actually made insurance more expensive, decreasing access to the poor and sick, while pricing out average Americans from affordable health care coverage. Millions more have been added to Medicaid, millions have seen double or triple their annual premiums and millions have opted not to be insured at all.

The Internal Revenue Service doesn’t tell the 10 million uninsured tax filers that their low and moderate incomes likely mean their households qualify for Medicaid or subsidies to buy coverage on the insurance exchanges.

In the March 8 rule, the Department of Health and Human Services (HHS) stated that Health Savings Account (HSA) eligibility was not a meaningful distinction for health plans because consumers can determine whether a plan is HSA-qualified by examining a plan’s cost-sharing amounts. Therefore, it will not require HSA-qualified plans to be designated as such.

Two main reasons why HSA-qualified plans will not survive is because plans must cover services below the deductible that are not considered “preventative care.” And the plans must apply specific deductibles and out-of-pocket limits that are outside the requirements for HSA-qualified plans.

Most of the remaining non-elderly uninsured people in the U.S. likely won’t gain coverage, a new study released this week suggests.

The study, from the Urban Institute says that while some higher-income people who are uninsured will surely gain coverage as the penalties for not having insurance increase, the possibility for increased coverage is actually lower among those who have higher incomes than those who are eligible for financial assistance to cover insurance.

The Obama administration is trying once again to address a criticism that has dogged the president ever since his health care bill passed six years ago: they need to sell it better.

On Tuesday, the US Department of Health and Human Services is rolling out a new promotional video, which was provided to STAT first, to explain the changes the administration is making to the health care delivery system through the law.

It’s a three-minute, rapid-fire, visually driven attempt to make terms like “care coordination” and “electronic health records” something that an average person who is getting his or her knee operated on can actually understand.