A group of health policy analysts have collaborated on a set of proposals for replacing the Affordable Care Act (ACA) and also reforming other major portions of health care delivery, such as the tax treatment of employer-sponsored health insurance, Medicaid, Medicare, and Health Savings Accounts. Because so much attention has been paid to the repeal of the ACA by those who have opposed it, we believe it is important to focus on a serious proposal that could both replace this law and provide additional measures of reform, especially to the health care entitlement programs.

We believe our reform agenda represents such a proposal. Furthermore, none of us regards the pre-ACA health care system as an acceptable alternative.

On December 14, former Secretary of the Department of Health and Human Services Kathleen Sebelius made news by calling the decisions of Kansas and Missouri to turn down the Medicaid expansion contained in the Affordable Care Act “morally repugnant and economically stupid.”

Heated political rhetoric does not alter the fact that a state’s decision to expand Medicaid involves complicated tradeoffs.

Mere hours before a deadline to begin or renew insurance coverage through HealthCare.gov for Jan. 1, federal officials said consumers could have extra time to buy health plans. People who want to have ObamaCare coverage on the first day of 2016 now have until 11:59 p.m. PST on Thursday to sign up on the federal insurance exchange, the marketplace’s chief executive announced Tuesday night.

Instead of more federal regulation and subsidies, what U.S. health care needs is adoption of market principles, starting with broad empowerment of the patient-consumer. The proposals advanced in this volume would replace many counterproductive and outdated federal policies with practical, market-based reforms that aim to provide all Americans with access to high-quality health care at affordable prices.

Community Health Options, a not-for-profit co-op insurance company based in Maine that also sells health plans in New Hampshire, will limit individual enrollments later this month because of “higher-than-expected claims costs.”

It’s an inauspicious sign for the company, which was one of the few successful co-ops created by the Affordable Care Act. Twelve of the ACA’s 23 co-ops have folded or are in the process of closing down, all of which occurred this year.

Individuals who do not obtain health coverage, through any source, are subject to a tax penalty unless they meet certain exemptions. The penalties under the so-called individual mandate were phased in over a three-year period starting in 2014 and are scheduled to increase substantially in 2016. This analysis from the Kaiser Family Foundation provides estimates of the share of uninsured people eligible to enroll in the marketplaces who will be subject to the penalty, and how those penalties are increasing for 2016.

Those without health in­sur­ance have a lot to con­sider. On one hand, the fine for re­main­ing un­in­sured steeply in­creases for next year. On the oth­er, the cost of the in­di­vidu­al man­date pen­alty is cheap­er than buy­ing the least ex­pens­ive in­sur­ance plan for 7.1 mil­lion of the nearly 11 mil­lion un­in­sured eli­gible to en­roll in health ex­changes, ac­cord­ing to a Kais­er Fam­ily Found­a­tion ana­lys­is re­leased Wed­nes­day.

The penalty for failing to have health insurance is going up next year, perhaps even higher than expected. Among uninsured individuals who are not exempt from the ObamaCare penalty, the average household fine for not having insurance in 2015 will be $661, rising to $969 per household in 2016, according to a Kaiser Family Foundation analysis.

The Justice Department last month asked the Supreme Court to review a preliminary injunction blocking the Obama administration from implementing the president’s immigration executive order, which would defer deportations for up to five million undocumented immigrants. Employers aren’t required to offer ObamaCare coverage or subsidies to these immigrants. The statutory language in the Affordable Care Act says that only “lawful residents” are eligible, and the government’s petition specifically notes that the immigration action does not “confer any form of legal status in this country.” In short, companies will be encouraged to hire these immigrants over U.S. citizens.

“Taxpayers should not be forced to throw good money after bad,” Grace-Marie Turner said in an interview with LifeZette. Turner is president of the Galen Institute, a not-for-profit health and tax policy research organization. “Congress would be well advised to exercise its oversight function to ensure no additional federal dollars are wasted on the program, as well as investigate how the taxpayer loans have been spent and who will pay it back,” she said.